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Breast cancer is the top cancer diagnosed in women, and the annual incidence of breast cancer is increasing.
In conjunction with Breast Cancer Awareness Month, Dr Lim Geok Hoon, Senior Consultant from the KK Breast Department at KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group, will address your questions about breast cancer.
This forum is open from 1 Oct to 28 Oct 2019.
If you have problems posting your questions, please email your questions to marcom@healthxchange.com.sg
Kindly note: Your question will go live/appear when the doctor answers it
Dear Dr Lim Geok Hoon,
I have a breast cyst for several years now, can breast cyst become breast cancer?
Can exercise/sport help prevent cancer?
Thank you
Answered by Dr Lim Geok Hoon, Senior Consultant from the KK Breast Department at KK Women's and Children's Hospital (KKH)
Dear Lucy,
Most of the times, breast cysts are non-cancerous. If you had this breast cyst for many years and there was no change in the cyst size and features over these years, then this cyst is unlikely to become breast cancer.
Regular exercise has several benefits and may lower your chance of getting breast cancer. However, it will not prevent breast cancer altogether.
Posted by F Ahmed
Dear Doctor,
My daughter is 15. She has got few lumps on her right breast. Size: 5.0X3.2 cm, 2.6X1.5 cm and 3.0X1.6 cm. After necessary examination through ultra sound and FNAC doctors confirmed that it is Fibroadenoma and recommended surgery to fully remove this.
I went through available literatures on Fibroadenoma on internet and came to know that in most cases doctor don’t recommend any surgery as often it naturally removes. So usually doctors observe the lump/s for a period and go for surgery only if there are some special situations.
I am a bit confused and therefore looking for your opinion. Would highly appreciate your response.
Dear F Ahmed,
As you have rightly pointed out, fibroadenoma is a benign condition. However, there are certain situations that will require removal. In this case, I will recommend that you arrange for your daughter to be examined by a specialist. Together with your daughter’s breast imaging and fine needle aspiration cytology (FNAC) results, the specialist can individualise a treatment plan for your daughter.
Posted by J Lee
Hi,
My mum was diagnosed with breast cancer in her 60s. The doctor told her that her cancer was genetic and not caused by hormones, so she was not given any chemo post breast resection. Since it is genetic, is there anything my sisters and I can do to reduce our risk of getting breast cancer? Thanks
Dear J Lee,
Based on what you had shared, if your mother’s cancer is truly due to a genetic cause, your mother would most probably had undergone a genetic blood test to confirm the genetic cause. If a genetic mutation is detected in your mother, then you and your sisters can also go for genetic testing. If any of you are tested positive for genetic mutation, then you could undergo prophylactic bilateral mastectomy, like what Angeline Jolie did, as one of the options to reduce the risk of breast cancer. There are also other ways to reduce breast cancer risks which are recommended only for high-risk genetic mutation carriers. Please seek a further assessment with a breast specialist.
Posted by S Teo
Hi Dr Lim,
I did an ultrasound in April 2019 and note that there’s a septated cyst at 11 o’clock measuring 2cm from nipple but no solid component was found. I could not really feel this 11 o’clock cyst at that point of time or maybe it was not noticeable to me during then.
I also had a lobulated tall nodule which I had later done a biopsy for in May and the results is just mildly inflamed cyst with no papillary structures.
Recently I find that the 11 o’clock septated cyst got more obvious as in i can feel it as a lump and if I press down with pressure, I can feel very slight pain. My question is am I required or when do you think will be more suitable to come back for another ultrasound again given that I just did one in April 2019? Thanks.
Dear S Teo,
If you had now found a breast lump which was more obvious, please kindly make an appointment for another consultation. As new breast lesions can occur anytime, we need to be sure that the lump that you are feeling is truly the 11 o’clock cyst and not a new breast lesion around the same area, which had appeared in the interim since your last consult this year. I would generally advise a consultation first so that the most appropriate type of breast imaging for you can be ordered.
Posted by Ms Ker
Hi Doctor
I am in my early 30s. My mum has breast cancer at 55 years old and my Grandmother has uterus cancer at age 65.
Is it a huge cause of concern if I:
Dear Ms Ker,
In general, adopting a healthy and balanced diet and regular exercise help to maintain health. However, even if you perform regular exercise and have a healthy diet, these measures do not guarantee that you will not develop breast cancer in your lifetime. As for your multiple breast lumps, please seek further assessment with a specialist to exclude a cancer in any of these lumps.
Posted by Saran
I was very traumatised by my last breast screening session. I absolutely dislike the mammogram machine.
Science has advanced so much in these recent years. But breast cancer testing is still seem so ancient and uncomfortable.
So my question is are there new alternatives of breast cancer screening besides the mammogram.
How accurate is the genetic testing?
If I find out I’m high risk - can I choose to carry out mastectomy for both my breast and cosmetically rebuild them. How long is the downtime from mastectomy and recovery from the whole process. Can the cosmetic rebuilding of breast be done immediately after the mastectomy?
Dear Saran,
I am sorry to hear about your last mammogram experience. However, a mammogram is still the recommended way for screening early breast cancer. Other methods have limitations or are still experimental.
To decrease the discomfort associated with mammogram, you could try scheduling your mammogram on the week after your period. You may also consider taking a mild painkiller, such as paracetamol, before the mammogram. Also, please communicate your concerns to the mammographer attending to you so that she can make adjustments accordingly. These measures may make your next mammogram less uncomfortable.
Genetic testing involves the testing of certain genes which are currently known to cause breast cancer. If it is performed in a validated laboratory, the results are quite accurate. It is also most informative when the test result is positive for a genetic mutation, then your risk for breast cancer will be markedly increased. If tested negative, unfortunately, you may still get breast cancer in your lifetime, probably due to other risk factors or other gene mutations which are still unknown for testing. Having said this, genetic testing is indicated only for certain groups of patients.
If you are truly confirmed to be at high risk for breast cancer by your doctor, you can undergo mastectomy for both breasts and rebuild them cosmetically. The hospitalisation stay may range from five days to about two weeks or longer, depending on the success of the operation. Most people would return to work about four to six weeks after operation. The cosmetic rebuilding of the breast is best done immediately after the mastectomy for the best cosmetic outcome, unless there are certain reasons to delay the rebuilding the breasts, such as the patient is unfit for long operations, etc
Posted by Gee
My questions:
Dear Gee,
It does not mean that you will definitely get breast cancer in your lifetime if your mother had breast cancer. Unless your mother’s breast cancer was related to a genetic cause and you also inherited that gene, then your chances of getting breast cancer will be markedly elevated.
However, I also understand that you are now 51 years old and still free from breast cancer, hence the chance of a genetic-related breast cancer is not high.
Microcalcifications can be harmless findings, especially if they had not changed for a long time. In these cases, these stable microcalcifications can be left alone. Your doctor will be the best person to reassure you about your microcalcifications.
Posted by J C
Dear Mdm,
I have completed the treatments for breast and lymph nodes cancer.
Done right side mastectomy on 7/6/18, sentinel lymph nodes removal, 8 cycles of chemo, 15x radiotherapies, 18 jabs of SC Herceptin because it was triple +ve, taking Nolvadex D since 26/12/18.
Can you please advise me if I need to remove Mirena (had prolonged 6 mths menses in 2015), ovaries (one side dried), uterus and cervix? To prevent chance of relapse?
Last ultrasound 2 weeks ago, discovered a 4.8mm cyst on left side of the breast. It's same place of which a cyst was removed in 2000 and excretion on 7/6/18 because there were 3 cysts on different parts in same breast, 2 o'clock, 5 o'clock and 11 o'clock. Therefore, this cyst is 3rd time in same place. What should I do about it?
What is the survival rate for me? Heart functioning at 58.5% after Herceptin 600ml SC x 18 cycles.
My mum deceased at 49 yrs old due to uterus cancer, elder sister had cervical cancer 5 yrs ago. So, is it genetic?
Your kind and professional advice would be appreciated. Thanks.
Dear J C,
Depending on the reason why Mirena is needed in your case and the stage of your breast cancer, you may wish to discuss further with your breast specialist and gynaecologist on the risks and benefits of keeping Mirena. In general, there are currently limiteddata about the link of breast cancer and Mirena, though the use of hormonal contraception is generally not advised in breast cancer patients.
Although removing the ovaries will decrease the chances of breast cancer relapse, it may carry some risks associated with premature menopause. Certain factors, such as age, desire for further children and characteristics of breast cancer, etc, are taken into consideration when deciding whether the ovaries, uterus and cervix are to be removed. As such, it is best that you discuss with your breast specialist on your most suitable treatment plan.
Cysts are generally harmless, especially if they do not exhibit any suspicious features on imaging. It is most appropriate that the doctor reviews your ultrasound images and reports to determine your next course of action.
Survival rate is dependent on multiple factors which include your co-existing medical conditions and the stage of your breast cancer, which includes the size of your breast cancer and the number of lymph nodes involved, etc. Your breast specialist who knows your condition the best will be the most ideal person to advise you on your survival rate.
I am sorry about your mother and your sister. Although it is unlikely that their cancers and your breast cancer are linked to a genetic cause based on what you had shared, a full assessment can only be made after a detailed family history and/or genetic testing. As a result, I would recommend that you consult your breast specialist who knows your case to do a more detailed assessment.
Posted by C C
Dear Dr Lim,
Per ultrasound - Right small solid nodule likely a fibroadenoma with well defined hypoecheic lesion seen measuring 5mm. The Axillae are unremarkable. Best option is to observe and re- scan 6 months later or see a surgeon for biopsy of the lesion immediately? Your advice please. Thanks.
Dear CC,
Your ultrasound report suggests that you have a right breast lesion which has favourable features. However, I will still recommend a consultation with your doctor, who could also examine you, in order to correlate your ultrasound findings with your physical examination. In this way, the most suitable treatment could be planned for you.
